Examining the Role of Wearables in Inflammatory Arthritis Care: A Narrative Literature Review

Clinical Snapshot

Key Findings

• P Value: Not reported at the review level

• Effect Size: Not pooled; individual study effect sizes are referenced qualitatively. No meta-analytic summary statistic is reported

• Primary Outcome: Wearable accelerometers can objectively quantify reduced physical activity and disrupted sleep in patients with IA, and these metrics correlate with clinical measures of disease activity across RA, PsA, and axSpA

• Nnt Or Sensitivity: Not applicable; no diagnostic accuracy or therapeutic NNT data are synthesised. The review is descriptive and exploratory in nature

• Confidence Interval: Not reported at the review level

Clinical Application

Consumer-grade wearable accelerometers (e.g., Fitbit, Actigraph, Apple Watch) are widely available and relatively low-cost, making adoption feasible in principle. However, clinical integration requires validated data pipelines, clinician training, and clear protocols for acting on wearable-derived signals. Reimbursement pathways and EHR integration remain significant implementation barriers in most healthcare systems In Australia, wearable technology for IA monitoring is not currently supported by PBS reimbursement or formal TGA-cleared clinical decision support pathways. The RACGP and Australian Rheumatology Association (ARA) have not yet issued specific guidelines on wearable integration in IA management. However, the Australian Digital Health Agency's national digital health strategy and the growing telehealth infrastructure post-COVID-19 provide a supportive policy environment for future integration. Biologics and targeted synthetic DMARDs used in IA (e.g., TNF inhibitors, IL-17 inhibitors, JAK inhibitors) are PBS-listed, and wearable-derived flare detection could theoretically optimise treatment timing and reduce unnecessary dose escalation — a clinically and economically relevant consideration in the PBS context. Aboriginal and Torres Strait Islander populations with IA face additional barriers to wearable adoption including digital access inequity, which is not addressed in this review. Adults with established diagnoses of RA, PsA, or axSpA who are under active rheumatological care and have access to wearable technology. Findings are most directly applicable to patients in tertiary rheumatology settings with digital health infrastructure

Abstract

Rheumatoid arthritis, psoriatic arthritis, and axial spondyloarthritis are types of inflammatory arthritis (IA) characterized by joint pain and stiffness that, despite therapeutic advances, remain difficult to treat. Changes in physical activity (PA) and sleep patterns may provide insights into IA disease course and activity. Wearable accelerometers have been validated as reliable, objective measures of PA and have provided insight into IA disease activity and progression through both PA and sleep metrics. Further, the granular nature of accelerometry data may provide the opportunity to identify early signals of treatment response or disease flares, leading to more effective and personalized therapeutic regimens in patients with IA. In this review, we summarize the current state of wearable technology in IA and explore the potential of wearables to bridge gaps in care.

References

1. 1.Hariharan, S., Chen, K., Kulkarni, A., Scher, J. U., Haberman, R. H., & Barua, S. (2026). Examining the role of wearables in inflammatory arthritis care: A narrative literature review. RMD Open. https://doi.org/10.1136/rmdopen-2024-004699